Nursing home (NH) residents with dementia comprise a majority of the NH resident population and are most likely to have long, clinically complex NH stays. These stays have been characterized by functional decline. Despite this, little is known about the dynamics of functional changes in these residents and the clinical correlates of these changes. The overall aim of this research is to determine the natural history of functional change among nursing home residents with dementia by focusing on modifiable clinical correlates of change. By so doing, we hope to improve resident's independence and the overall quality of care given to them. This research will elucidate the person-specific characteristics at the time of admission to determine how demographic and socioeconomic factors affect function. This will allow for identification of special needs at the time of admission and highlight methods for improving community-based. long-term care in order to maintain persons in the community. We will also study changes in resident function with a focus on how specific treatments and interventions, (e.g., medication use) affect function. To this end, we hope to elucidate ways to improve care in the nursing home with an emphasis on the promotion of independence and enrichment of the quality of life of the resident. To achieve the above, we plan a longitudinal analysis of two years of nursing home resident assessment data contained in the Minimum Data Set+ (hereafter, MDS). The MDS+ data set is a product of a Health Care Financing Administration (HCFA) funded Multi-state Nursing Home Case-mix and Quality Demonstration project. The MDS+ data set contains several hundred variables documented on each nursing home resident at admission and at quarterly intervals. It is a rich resource for socio-demographic , medical, functional, and behavioral measures. The MDS+ data set represents five states and contains approximately 1.5 million records. The principal investigator already has access and approval to use the data set for this type of research. Though epidemiological and statistical methods already employed in other work by the Principal Investigator, we will test our hypothesis to accomplish our goals.